NU 578 Units 1-5 Exam Pharmacology for Advanced Practice
Nurses | University of South Alaba | 200 Questions with Verified
Answers & Rationales 2026/2027
1. A 55-year-old male with hypertension is started on lisinopril. Which adverse effect is most
characteristic of ACE inhibitors?
A) Bradycardia
B) Dry cough
C) Hypokalemia
D) Tachycardia
Answer B: Dry cough
Rationale: ACE inhibitors block bradykinin breakdown, leading to cough. ARBs do not cause cough.
2. A client is prescribed metformin for type 2 diabetes. Which serious adverse effect requires
immediate discontinuation?
A) Weight gain
B) Lactic acidosis
C) Hypoglycemia
D) Diarrhea
Answer B: Lactic acidosis
Rationale: Metformin can cause lactic acidosis in renal impairment or hypoperfusion. GI side effects are
common but not emergent.
3. A patient with heart failure with reduced ejection fraction is prescribed carvedilol. Which
finding indicates the medication is having a therapeutic effect?
A) Increased heart rate
,B) Improved ejection fraction and reduced dyspnea
C) Weight gain
D) Hypotension
Answer B: Improved ejection fraction and reduced dyspnea
Rationale: Carvedilol improves LVEF and symptoms in HFrEF. Beta-blockers reduce mortality.
4. A patient with bipolar disorder is prescribed lithium. Which baseline laboratory tests are
essential?
A) Liver function tests
B) Thyroid, renal function, and pregnancy test
C) Complete blood count
D) Cardiac enzymes
Answer B: Thyroid, renal function, and pregnancy test
Rationale: Lithium affects thyroid and kidneys and is teratogenic. Monitor levels regularly (therapeutic
0.6-1.2 mEq/L).
5. A nurse is teaching a client about warfarin. Which statement indicates correct understanding?
A) “I can take ibuprofen for headaches.”
B) “I will have my INR checked regularly.”
C) “I can eat as many green vegetables as I want.”
D) “I will stop warfarin if I feel well.”
Answer B: “I will have my INR checked regularly.”
Rationale: INR monitoring is essential. Consistent vitamin K intake and avoid NSAIDs.
6. A patient on vancomycin develops flushing, rash, and itching during the infusion. Which action
should the nurse take first?
A) Administer diphenhydramine
B) Slow the infusion rate
,C) Stop the infusion
D) Notify the provider
Answer C: Stop the infusion
Rationale: Red man syndrome is infusion-related; stopping is first. Then slow rate and give
antihistamines.
7. A patient with type 2 diabetes is prescribed an SGLT2 inhibitor (empagliflozin). Which adverse
effect should the nurse teach?
A) Weight gain
B) Genital yeast infections and euglycemic DKA
C) Hypoglycemia
D) Hyperkalemia
Answer B: Genital yeast infections and euglycemic DKA
Rationale: SGLT2 inhibitors increase glucose excretion in urine, leading to yeast infections and risk of
euglycemic DKA.
8. A patient is prescribed an MAOI (phenelzine). Which food should be avoided?
A) Broiled chicken
B) Aged cheese and cured meats
C) Fresh fruits
D) White rice
Answer B: Aged cheese and cured meats
Rationale: Tyramine-rich foods (aged cheese, cured meats, fermented foods) cause hypertensive crisis.
9. A patient is receiving IV heparin for a pulmonary embolism. Which lab value is used to monitor
therapy?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
, C) International normalized ratio (INR)
D) Platelet count
Answer B: Activated partial thromboplastin time (aPTT)
Rationale: aPTT monitors heparin; PT/INR monitors warfarin. Platelets monitor HIT.
10. A patient with schizophrenia is prescribed clozapine. Which laboratory monitoring is required?
A) Liver function tests
B) Absolute neutrophil count (ANC)
C) Thyroid function tests
D) Serum glucose
Answer B: Absolute neutrophil count (ANC)
Rationale: Clozapine causes agranulocytosis; ANC monitored weekly for 6 months, then every 2 weeks.
11. A patient with asthma is prescribed albuterol. Which receptor mediates bronchodilation?
A) Beta-1 adrenergic
B) Beta-2 adrenergic
C) Muscarinic M3
D) Alpha-1 adrenergic
Answer B: Beta-2 adrenergic
Rationale: Albuterol is a beta-2 agonist that relaxes bronchial smooth muscle.
12. A patient with Parkinson’s disease is started on carbidopa-levodopa. The purpose of carbidopa
is to:
A) Cross the blood-brain barrier
B) Prevent peripheral conversion of levodopa to dopamine
C) Act as a dopamine agonist
D) Reduce dyskinesias
Answer B: Prevent peripheral conversion of levodopa to dopamine
Nurses | University of South Alaba | 200 Questions with Verified
Answers & Rationales 2026/2027
1. A 55-year-old male with hypertension is started on lisinopril. Which adverse effect is most
characteristic of ACE inhibitors?
A) Bradycardia
B) Dry cough
C) Hypokalemia
D) Tachycardia
Answer B: Dry cough
Rationale: ACE inhibitors block bradykinin breakdown, leading to cough. ARBs do not cause cough.
2. A client is prescribed metformin for type 2 diabetes. Which serious adverse effect requires
immediate discontinuation?
A) Weight gain
B) Lactic acidosis
C) Hypoglycemia
D) Diarrhea
Answer B: Lactic acidosis
Rationale: Metformin can cause lactic acidosis in renal impairment or hypoperfusion. GI side effects are
common but not emergent.
3. A patient with heart failure with reduced ejection fraction is prescribed carvedilol. Which
finding indicates the medication is having a therapeutic effect?
A) Increased heart rate
,B) Improved ejection fraction and reduced dyspnea
C) Weight gain
D) Hypotension
Answer B: Improved ejection fraction and reduced dyspnea
Rationale: Carvedilol improves LVEF and symptoms in HFrEF. Beta-blockers reduce mortality.
4. A patient with bipolar disorder is prescribed lithium. Which baseline laboratory tests are
essential?
A) Liver function tests
B) Thyroid, renal function, and pregnancy test
C) Complete blood count
D) Cardiac enzymes
Answer B: Thyroid, renal function, and pregnancy test
Rationale: Lithium affects thyroid and kidneys and is teratogenic. Monitor levels regularly (therapeutic
0.6-1.2 mEq/L).
5. A nurse is teaching a client about warfarin. Which statement indicates correct understanding?
A) “I can take ibuprofen for headaches.”
B) “I will have my INR checked regularly.”
C) “I can eat as many green vegetables as I want.”
D) “I will stop warfarin if I feel well.”
Answer B: “I will have my INR checked regularly.”
Rationale: INR monitoring is essential. Consistent vitamin K intake and avoid NSAIDs.
6. A patient on vancomycin develops flushing, rash, and itching during the infusion. Which action
should the nurse take first?
A) Administer diphenhydramine
B) Slow the infusion rate
,C) Stop the infusion
D) Notify the provider
Answer C: Stop the infusion
Rationale: Red man syndrome is infusion-related; stopping is first. Then slow rate and give
antihistamines.
7. A patient with type 2 diabetes is prescribed an SGLT2 inhibitor (empagliflozin). Which adverse
effect should the nurse teach?
A) Weight gain
B) Genital yeast infections and euglycemic DKA
C) Hypoglycemia
D) Hyperkalemia
Answer B: Genital yeast infections and euglycemic DKA
Rationale: SGLT2 inhibitors increase glucose excretion in urine, leading to yeast infections and risk of
euglycemic DKA.
8. A patient is prescribed an MAOI (phenelzine). Which food should be avoided?
A) Broiled chicken
B) Aged cheese and cured meats
C) Fresh fruits
D) White rice
Answer B: Aged cheese and cured meats
Rationale: Tyramine-rich foods (aged cheese, cured meats, fermented foods) cause hypertensive crisis.
9. A patient is receiving IV heparin for a pulmonary embolism. Which lab value is used to monitor
therapy?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
, C) International normalized ratio (INR)
D) Platelet count
Answer B: Activated partial thromboplastin time (aPTT)
Rationale: aPTT monitors heparin; PT/INR monitors warfarin. Platelets monitor HIT.
10. A patient with schizophrenia is prescribed clozapine. Which laboratory monitoring is required?
A) Liver function tests
B) Absolute neutrophil count (ANC)
C) Thyroid function tests
D) Serum glucose
Answer B: Absolute neutrophil count (ANC)
Rationale: Clozapine causes agranulocytosis; ANC monitored weekly for 6 months, then every 2 weeks.
11. A patient with asthma is prescribed albuterol. Which receptor mediates bronchodilation?
A) Beta-1 adrenergic
B) Beta-2 adrenergic
C) Muscarinic M3
D) Alpha-1 adrenergic
Answer B: Beta-2 adrenergic
Rationale: Albuterol is a beta-2 agonist that relaxes bronchial smooth muscle.
12. A patient with Parkinson’s disease is started on carbidopa-levodopa. The purpose of carbidopa
is to:
A) Cross the blood-brain barrier
B) Prevent peripheral conversion of levodopa to dopamine
C) Act as a dopamine agonist
D) Reduce dyskinesias
Answer B: Prevent peripheral conversion of levodopa to dopamine
